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  • 1
    In: Cancer Research, American Association for Cancer Research (AACR), Vol. 78, No. 13_Supplement ( 2018-07-01), p. 4240-4240
    Abstract: Background: Breast cancer prognosis depends on stage at diagnosis and varies by intrinsic tumor subtype. In the US, the distribution of tumor subtypes has been shown to differ between racial/ethnic groups with African American and Latina women more likely to be diagnosed with the more aggressive “triple negative” breast cancer (TNBC) compared to Non-Latino White women. Latinos in the US originate from different countries with different cultures and ancestral genetic backgrounds, demonstrating the heterogeneity that exists. Information about the distribution of tumor subtypes in Latin American regions is limited. Methods: Data for these analyses come from The Peruvian National Cancer Institute . Includes clinical information for 303 patients diagnosed with breast cancer between 2010 and 2015 and who are members of Indigenous American communities. We analyzed women from different groups: the Quechuas (Group 1; N=223), Aimara (Group 2; N=9), Ashankinka/Nomatsigenga/Yenesha (Group 3; N=17), Awajun/Kichwa/Shawi/Shipibo-Konibo (Group 4; N=29) and other communities (Group 5; N=20). Some communities were combined based on previous literature describing their genealogical proximity. We compared tumor characteristics and survival between these groups using Fisher exact tests, T-tests, and a Cox Proportional Hazards model with predictors age at diagnosis, stage, tumor subtype, and treatment. Breast cancer subtype was defined as luminal A (ER/PR+/HER2-), luminal B (ER+/HER2+), HER2 overexpressing (ER/PR- HER2+) and triple negative (ER/PR- HER2-) based on immunohistochemistry. Results: Overall, tumors from the 303 Indigenous American women included in the present study were 37% luminal A, 20% luminal B, 23% HER2 overexpressing and 19% triple negative. Our analyses showed that women from group 1 were diagnosed at an older age (55 vs. 48-50, p & lt;0.0001) and less frequently with TNBC compared to women from other groups (45% vs. 55-78%, p=0.06). Compared to group 1, women from the other groups a non-significant trend towards higher mortality (HR 1.5-1.9, p=0.272). In the full model, including age, stage, tumor subtype and treatment, the trend was no longer apparent. Whether the women had surgery had the strongest effect on survival (p=0.001) followed by stage (p=0.0012) and TNBC (p=0.0023). Conclusion: Differences in survival between the women of different indigenous communities with breast cancer in Peru are most likely due to differences in access to care. There could be environmental factors or subtle sub continental genetic differences influencing the risk of TNBC. However, the lower frequency of TNBC among the Quechuas could also be due to a reduced set of logistic barriers. The limited power of this study demonstrates the need for larger data sets for subgroup analysis in Latinas. The more we learn by analyzing diverse populations, the better equipped we will be to provide adequate care for all women. Citation Format: Lizeth I. Tamayo, Tatiana Vidaurre, Jeannie Navarro Vásquez, Sandro Casavilca, Jessica I. Aramburu, Monica Calderon, Daniel Cherry, Sikai Song, Garth H. Rauscher, Laura Fejerman. Breast cancer characteristics and survival among different Indigenous American communities in Peru [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2018; 2018 Apr 14-18; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2018;78(13 Suppl):Abstract nr 4240.
    Type of Medium: Online Resource
    ISSN: 0008-5472 , 1538-7445
    RVK:
    RVK:
    Language: English
    Publisher: American Association for Cancer Research (AACR)
    Publication Date: 2018
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  • 2
    Online Resource
    Online Resource
    American Association for Cancer Research (AACR) ; 2017
    In:  Cancer Research Vol. 77, No. 13_Supplement ( 2017-07-01), p. 5275-5275
    In: Cancer Research, American Association for Cancer Research (AACR), Vol. 77, No. 13_Supplement ( 2017-07-01), p. 5275-5275
    Abstract: Background: Breast cancer prognosis depends on stage at diagnosis and varies by intrinsic tumor subtype. In the US, the distribution of intrinsic subtypes has been shown to differ between racial/ethnic groups, with African American and Hispanic/Latina women more likely to be diagnosed with the more aggressive “triple negative” breast cancer (TNBC), lacking expression of estrogen receptor (ER), progesterone receptor (PR) and human epidermal growth factor receptor 2 (HER2), compared to Non-Hispanic/Latina White women. Hispanics/Latinos in the US are a heterogeneous group originating from different countries with different cultures and ancestral backgrounds. Information about the distribution of tumor subtypes in Latin American regions is lacking. Methods: Data for these analyses come from the Instituto Nacional de Enfermedades Neoplásicas (the Peruvian National Cancer Institute), which diagnoses and treats 20% of all breast cancers diagnosed in Peru. We have abstracted data from clinical records for 303 patients diagnosed with breast cancer between 2010 and 2015 and who self-reported as members of an Indigenous American community from the Andean Mountain region (indigenous subgroups: Quechuas, Aimaras, N=232) or the Amazonian region (indigenous subgroups: Shipibo-Konibo, Awajún, Ashaninka, Kichua, Ese Eja, Harakbut, Amahuaca, Shawi, Yanesha, Kakataibo, Nomatsigenga, N=71). We compared the distribution of age at diagnosis and tumor characteristics by region. Comparisons between the two regions were conducted using chi-squared tests, as well as a t-test for age at diagnosis. Breast cancer subtype was defined as luminal A (ER/PR+/HER2-), luminal B (ER+/HER2+), HER2 overexpressing (ER/PR- HER2+) and triple negative (ER/PR- HER2-) based on immunohistochemistry. Results: Overall, tumors from the 303 Indigenous American women from Peru included in the present study were 37% luminal A, 20% luminal B, 23% HER2 overexpressing and 19% triple negative. Our analyses showed that women from the Amazonian region were diagnosed at a younger age (50 vs. 55 mean age at diagnosis, P value =0.001), later stage (53.0% vs. 41.7% stage III or IV, P value=0.107) and more frequently with triple-negative tumors compared to women from the Mountain Region (30% vs. 16%, P value =0.115). Conclusion: Differences between Indigenous American women from the Amazonian and Mountain Range regions in Peru could be due to variation in genetic predisposition to particular subtypes of the disease, variation in environmental exposures, as well as to differences in cancer awareness and access to care between the different groups. The more we learn by analyzing diverse populations, subpopulations and revealing heterogeneity within Latin American women, the better equipped we will be to provide adequate care for all women. Citation Format: Lizeth I. Tamayo, Tatiana Vidaurre, Jeannie N. Vásquez, Sandro Casavilca, Jessica I. Palomino, Monica Calderon, Garth H. Rauscher, Laura Fejerman. Breast cancer characteristics among Indigenous American women from Peru [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2017; 2017 Apr 1-5; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2017;77(13 Suppl):Abstract nr 5275. doi:10.1158/1538-7445.AM2017-5275
    Type of Medium: Online Resource
    ISSN: 0008-5472 , 1538-7445
    RVK:
    RVK:
    Language: English
    Publisher: American Association for Cancer Research (AACR)
    Publication Date: 2017
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  • 3
    In: PLOS ONE, Public Library of Science (PLoS), Vol. 13, No. 9 ( 2018-9-5), p. e0201287-
    Type of Medium: Online Resource
    ISSN: 1932-6203
    Language: English
    Publisher: Public Library of Science (PLoS)
    Publication Date: 2018
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  • 4
    In: Frontiers in Oncology, Frontiers Media SA, Vol. 13 ( 2023-2-16)
    Abstract: Breast cancer is a heterogeneous disease, and the distribution of the different subtypes varies by race/ethnic category in the United States and by country. Established breast cancer-associated factors impact subtype-specific risk; however, these included limited or no representation of Latin American diversity. To address this gap in knowledge, we report a description of demographic, reproductive, and lifestyle breast cancer-associated factors by age at diagnosis and disease subtype for The Peruvian Genetics and Genomics of Breast Cancer (PEGEN-BC) study. Methods The PEGEN-BC study is a hospital-based breast cancer cohort that includes 1943 patients diagnosed at the Instituto Nacional de Enfermedades Neoplásicas in Lima, Peru. Demographic and reproductive information, as well as lifestyle exposures, were collected with a questionnaire. Clinical data, including tumor Hormone Receptor (HR) status and Human Epidermal Growth Factor Receptor 2 (HER2) status, were abstracted from electronic medical records. Differences in proportions and mean values were tested using Chi-squared and one-way ANOVA tests, respectively. Multinomial logistic regression models were used for multivariate association analyses. Results The distribution of subtypes was 52% HR+HER2-, 19% HR+HER2+, 16% HR-HER2-, and 13% HR-HER2+. Indigenous American (IA) genetic ancestry was higher, and height was lower among individuals with the HR-HER2+ subtype (80% IA vs. 76% overall, p =0.007; 152 cm vs. 153 cm overall, p =0.032, respectively). In multivariate models, IA ancestry was associated with HR-HER2+ subtype (OR=1.38,95%CI=1.06-1.79, p =0.017) and parous women showed increased risk for HR-HER2+ (OR=2.7,95%CI=1.5-4.8, p & lt;0.001) and HR-HER2- tumors (OR=2.4,95%CI=1.5-4.0, p & lt;0.001) compared to nulliparous women. Multiple patient and tumor characteristics differed by age at diagnosis ( & lt;50 vs. & gt;=50), including ancestry, region of residence, family history, height, BMI, breastfeeding, parity, and stage at diagnosis ( p & lt;0.02 for all variables). Discussion The characteristics of the PEGEN-BC study participants do not suggest heterogeneity by tumor subtype except for IA genetic ancestry proportion, which has been previously reported. Differences by age at diagnosis were apparent and concordant with what is known about pre- and post-menopausal-specific disease risk factors. Additional studies in Peru should be developed to further understand the main contributors to the specific age of onset and molecular disease subtypes in this population and develop population-appropriate predictive models for prevention.
    Type of Medium: Online Resource
    ISSN: 2234-943X
    Language: Unknown
    Publisher: Frontiers Media SA
    Publication Date: 2023
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  • 5
    In: Frontiers in Oncology, Frontiers Media SA, Vol. 12 ( 2023-1-6)
    Type of Medium: Online Resource
    ISSN: 2234-943X
    Language: Unknown
    Publisher: Frontiers Media SA
    Publication Date: 2023
    detail.hit.zdb_id: 2649216-7
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  • 6
    In: Cancer Epidemiology, Biomarkers & Prevention, American Association for Cancer Research (AACR), Vol. 32, No. 1_Supplement ( 2023-01-01), p. C071-C071
    Abstract: Background: Breast cancer is the most common cancer among women in the US and the leading cause of cancer death among women who self-identify as Hispanics/Latinas (H/L). Approximately 5-10% of breast cancer can be attributed to inherited genetic mutations in high penetrance genes such as BRCA1 and BRCA2. Studies have shown that genetic counseling can help women and their families make informed decisions about genetic testing, which in turn can lead to life-saving preventative strategies. H/L women are less likely to undergo genetic testing than Non-Hispanic White women. To address this disparity, we have developed a hereditary breast cancer outreach, education, and navigation program for Spanish-speaking Latinas in California. Materials and Methods: The “Tu Historia Cuenta” program is a promotores-based virtual outreach, education, and navigation program implemented in the cities of San Francisco, Sacramento, and Los Angeles. Participants responded to a demographic survey, a breast cancer family history survey, and a feedback survey. Survey responses were described for participants and compared by the area where the program took place using chi-square, Fisher exact tests, and t-tests. Multinomial logistic regression models were used for multivariate analyses. Results and Conclusion: We enrolled 1042 women, and 892 completed the family history survey. Among those who completed the survey, 62 (7%) were found to have a strong family history of breast cancer and qualified for referral to genetic counseling. We identified 272 women (42.8% of women aged 40 to 74 years) who were due for mammograms (64 of whom we have connected to a federally-funded screening program), 162 women (16% of women aged 25 to 65 years) due for Papanicolaou test, and 189 women (71.6% of women aged 50+) due for colonoscopy. Insurance rates differed across the three cities with San Francisco having the smallest proportion of uninsured individuals (9.3%) compared to Los Angeles and Sacramento (44.3% and 44%, respectively), which may be explained by differences in health care access. Through this study, we were able to connect with participants that are often excluded form research (35.8% of the study participants were uninsured and 48% were monolingual or had limited English proficiency). These results highlight the need for additional support for programs that spread awareness about cancer risk and facilitate access to resources, specifically within the H/L community. Citation Format: Lizeth I. Tamayo, Fabian Perez, Angelia Perez, Miriam Hernandez, Alejandra Martinez, Xiaosong Huang, Valentina Zavala, Elad Ziv, Susan L. Neuhausen, Luis Carvajal-Carmona, Ysabel Duron, Laura Fejerman. Cancer screening and breast cancer family history in Spanish-speaking Hispanic/Latina women in California [abstract]. In: Proceedings of the 15th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2022 Sep 16-19; Philadelphia, PA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2022;31(1 Suppl):Abstract nr C071.
    Type of Medium: Online Resource
    ISSN: 1538-7755
    Language: English
    Publisher: American Association for Cancer Research (AACR)
    Publication Date: 2023
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  • 7
    Online Resource
    Online Resource
    American Association for Cancer Research (AACR) ; 2018
    In:  Cancer Epidemiology, Biomarkers & Prevention Vol. 27, No. 7_Supplement ( 2018-07-01), p. B79-B79
    In: Cancer Epidemiology, Biomarkers & Prevention, American Association for Cancer Research (AACR), Vol. 27, No. 7_Supplement ( 2018-07-01), p. B79-B79
    Abstract: Background: Breast cancer prognosis depends on stage at diagnosis and varies by intrinsic tumor subtype. In the US, the distribution of intrinsic subtypes has been shown to differ between racial/ethnic groups with African American and Hispanic/Latina women more likely to be diagnosed with the more aggressive triple-negative breast cancer (TNBC) lacking expression of estrogen receptor (ER), progesterone receptor (PR), and human epidermal growth factor receptor 2 (HER2), compared to non-Hispanic/Latino White women. Hispanics/Latinos in the US are a heterogeneous group originating from different countries with different cultures and ancestral backgrounds. Information about the distribution of tumor subtypes in Latin American regions is lacking. Methods: Data for these analyses come from the Instituto Nacional de Enfermedades Neoplásicas (the Peruvian National Cancer Institute), which diagnoses and treats ~20% of all breast cancers diagnosed in Peru. We have abstracted data from clinical records for 303 patients diagnosed with breast cancer between 2010 and 2015 and who are members of Indigenous American communities from the Andean Mountain region (N=232) or the Amazonian region (N=71). We compared tumor characteristics and survival between the two groups. Comparisons between the two regions were conducted using chi-squared tests, as well as a t-test for age at diagnosis. Breast cancer subtype was defined as luminal A (ER/PR+/HER2-), luminal B (ER+/HER2+), HER2 overexpressing (ER/PR- HER2+), and triple-negative (ER/PR- HER2-) based on immunohistochemistry. Survival analyses were conducted using a Cox proportional hazards model and included region, age at diagnosis, stage, and tumor subtype as predictors. Results: Overall, tumors from the 303 Indigenous American women from Peru included in the present study were 37% luminal A, 20% luminal B, 23% HER2 overexpressing, and 19% triple-negative. Our analyses showed that women from the Amazonian region were diagnosed at a younger age (50 vs. 55 mean age at diagnosis, P value =0.001), later stage (61% vs. 48% stage III or IV, P value=0.06), and more frequently with triple-negative tumors compared to women from the Mountain region (31% vs. 17%, P value =0.013). Women from the Amazonian region had a 70% higher mortality hazard than the women from the Mountain region in a model adjusted by age at diagnosis (hazard ratio 1.73, 95%CI 1.06-2.86, p=0.027). In the full model including stage and tumor subtype, the difference in the mortality hazard was no longer statistically significant (HR 1.20, 95%CI 0.71-2.03, p=0.493). Conclusion: Differences in tumor characteristics and survival between Indigenous American women from the Amazonian and Mountain Range regions in Peru could be due to variation in genetic predisposition to particular subtypes of the disease, variation in environmental exposures, as well as to differences in cancer awareness and access to care between the different groups. The more we learn by analyzing diverse populations and subpopulations and revealing heterogeneity within Latin American women, the better equipped we will be to provide adequate care for all women. Citation Format: Lizeth I. Tamayo, Tatiana Vidaurre, Jeannie Navarro Vasquez, Sandro Casavilca, Jessica Ivonne Aramburu Palomino, Monica Calderon, Garth H. Rauscher, Laura Fejerman. Breast cancer characteristics and survival among Indigenous American women from Peru [abstract]. In: Proceedings of the Tenth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2017 Sep 25-28; Atlanta, GA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2018;27(7 Suppl):Abstract nr B79.
    Type of Medium: Online Resource
    ISSN: 1055-9965 , 1538-7755
    Language: English
    Publisher: American Association for Cancer Research (AACR)
    Publication Date: 2018
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  • 8
    In: Cancer Research, American Association for Cancer Research (AACR), Vol. 80, No. 9 ( 2020-05-01), p. 1893-1901
    Abstract: Women of Latin American origin in the United States are more likely to be diagnosed with advanced breast cancer and have a higher risk of mortality than non-Hispanic White women. Studies in U.S. Latinas and Latin American women have reported a high incidence of HER2 positive (+) tumors; however, the factors contributing to this observation are unknown. Genome-wide genotype data for 1,312 patients from the Peruvian Genetics and Genomics of Breast Cancer Study (PEGEN-BC) were used to estimate genetic ancestry. We tested the association between HER2 status and genetic ancestry using logistic and multinomial logistic regression models. Findings were replicated in 616 samples from Mexico and Colombia. Average Indigenous American (IA) ancestry differed by subtype. In multivariate models, the odds of having an HER2+ tumor increased by a factor of 1.20 with every 10% increase in IA ancestry proportion (95% CI, 1.07–1.35; P = 0.001). The association between HER2 status and IA ancestry was independently replicated in samples from Mexico and Colombia. Results suggest that the high prevalence of HER2+ tumors in Latinas could be due in part to the presence of population-specific genetic variant(s) affecting HER2 expression in breast cancer. Significance: The positive association between Indigenous American genetic ancestry and HER2+ breast cancer suggests that the high incidence of HER2+ subtypes in Latinas might be due to population and subtype-specific genetic risk variants.
    Type of Medium: Online Resource
    ISSN: 0008-5472 , 1538-7445
    RVK:
    RVK:
    Language: English
    Publisher: American Association for Cancer Research (AACR)
    Publication Date: 2020
    detail.hit.zdb_id: 2036785-5
    detail.hit.zdb_id: 1432-1
    detail.hit.zdb_id: 410466-3
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  • 9
    In: Frontiers in Oncology, Frontiers Media SA, Vol. 12 ( 2022-10-26)
    Abstract: Breast cancer is the most common cancer among women in the U.S. and the leading cause of cancer death among Hispanics/Latinas (H/L). H/L are less likely than Non-H/L White (NHW) women to be diagnosed in the early stages of this disease. Approximately 5-10% of breast cancer can be attributed to inherited genetic mutations in high penetrance genes such as BRCA1/2 . Women with pathogenic variants in these genes have a 40-80% lifetime risk of breast cancer. Past studies have shown that genetic counseling can help women and their families make informed decisions about genetic testing and early cancer detection or risk-reduction strategies. However, H/L are 3.9-4.8 times less likely to undergo genetic testing than NHW women. We developed a program to outreach and educate the H/L community about hereditary breast cancer, targeting monolingual Spanish-speaking individuals in California. Through this program, we have assessed cancer screening behavior and identified women who might benefit from genetic counseling in a population that is usually excluded from cancer research and care. Materials and Methods The “Tu Historia Cuenta” program is a promotores-based virtual outreach and education program including the cities of San Francisco, Sacramento, and Los Angeles. Participants responded to three surveys: a demographic survey, a breast cancer family history survey, and a feedback survey. Survey responses were described for participants and compared by area where the program took place using chi-square, Fisher exact tests, and t tests. Multinomial logistic regression models were used for multivariate analyses. Results and Conclusion We enrolled 1042 women, 892 completed the cancer family history survey and 62 (7%) provided responses compatible with referral to genetic counseling. We identified 272 women (42.8% ages 40 to 74 years) who were due for mammograms, 250 women (24.7% ages 25 to 65 years) due for Papanicolaou test, and 189 women (71.6% ages 50+) due for colorectal cancer screening. These results highlight the need of additional support for programs that spread awareness about cancer risk and facilitate access to resources, specifically within the H/L community.
    Type of Medium: Online Resource
    ISSN: 2234-943X
    Language: Unknown
    Publisher: Frontiers Media SA
    Publication Date: 2022
    detail.hit.zdb_id: 2649216-7
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